Improving internet-delivered therapy

benny and family

Since mid-March of 2013, I’ve been a proud member of the Bulik Lab. Sandra (my wife), Alan (our 22-month old son), and I will stay in North Carolina for 6 months, so it is hard to believe that almost half of our time is already over! I received my PhD in psychology from the University of Heidelberg and worked at the Center for Psychotherapy Research. My research focuses on the potential of computer-mediated communication to improve outcomes of psychotherapy.

My research project capitalizes on a unique opportunity to analyze data from an ambitious and innovative ongoing clinical trial comparing online vs. face-to-face CBT for bulimia nervosa.  Since 2008, UNC Center of Excellence for Eating Disorders and the Western Psychiatric Institute and Clinic (WPIC) at the University of Pittsburgh Medical Center have been conducting an innovative study called CBT4BN. The purpose of the trial is to determine whether manualized cognitive-behavioral therapy (CBT) delivered online has similar measurable outcomes to the gold standard of manualized face-to-face group CBT. The group setting of the internet-based version is conducted via moderated therapeutic chat groups. I will use the automatically stored transcripts of these online chats to analyze the nature of therapeutic factors reflected in communication patterns and to explore the impact of communication on therapeutic processes.

Why is this interesting? Even though psychotherapy research has consistently demonstrated that psychotherapy is effective, there is no evidence-based explanation of how interventions lead to change. The exploration of process characteristics to enhance the efficacy of CBT is critical to further develop effective treatments in the area. I will try to find text-based process variables (for example, number of words and statements posted by the participants) that are correlated with post-group evaluations and overall treatment outcome. The results of the proposed project will have clear implications for the adaptation of evidence-based treatments for internet delivery. Improved knowledge about therapeutic online communication could enable us to better tailor therapy delivery according to the individual patients’ characteristics. If significant process-outcome correlations are found, they could be used to provide feedback about the probability to benefit from the therapy and give advice if group sessions or treatment are likely to fail. Results will also help us tailor and further develop Internet-based treatments so that individuals who live in rural areas or other areas far from centers that provide cognitive-behavioral therapy will be able to benefit from evidence-based treatment.

Thanks to all patients and therapists who took part in the study, and thanks to Cindy Bulik and her team for having and supporting me! Finally, thanks to the DAAD (German Academic Exchange Service) for granting me a postdoctoral fellowship to conduct research at UNC.

By: Benjamin Zimmer, PhD